Abstract： Objective To investigate the efficacy of postoperative concurrent chemoradiotherapy for early-stage cervical adenosquamous carcinoma and adenocarcinoma. Methods A total of 62 patients with cervical adenosquamous carcinoma, 149 patients with cervical adenocarcinoma, and 2687 patients with cervical squamous cell carcinoma, all of whom were in stage ⅠB-ⅡA and were treated from 2006 to 2012, were enrolled, and some of them received postoperative pelvic radiotherapy±para-aortic extended field radiation±afterloading radiotherapy. The chemotherapy regimen consisting of DDP, TP, and FP was given to these patients. The chi-square test was used for comparison of general clinical data, the Kaplan-Meier method was used for calculating survival rates, and the log-rank test was used for survival difference analysis. Results Cervical adenosquamous carcinoma and adenocarcinoma had no significant differences in clinicopathological features (P=0.107-0.639). The high-risk patients with adenocarcinoma had a higher recurrence rate than their low-risk counterparts even after adjuvant radiotherapy or chemoradiotherapy (P=0.000).In the patients treated with surgery and radiotherapy, those with adenosquamous carcinoma had the shortest median survival time, followed by those with adenocarcinoma and squamous cell carcinoma (P=0.134,0.787);in the patients treated with surgery and concurrent chemoradiotherapy, those with adenocarcinoma had the shortest median survival time , followed by those with adenosquamous carcinoma and squamous cell carcinoma (P=0.131,0.643), and the median survival time showed a significant difference between the patients with adenocarcinoma and those with squamous cell carcinoma (P=0.000). In the patients with adenosquamous carcinoma and adenocarcinoma, the patients treated with postoperative concurrent chemoradiotherapy had higher incidence rates of short-term adverse reactions than those treated with postoperative radiotherapy (P=0.037,0.003), but the incidence rates of long-term adverse reactions showed no difference between the two groups of patients (P=0.861,0.655). In the patients with adenosquamous carcinoma, the patients treated with postoperative concurrent chemoradiotherapy had a lower rate of distant metastasis (P=0.003) and prolonged median overall survival anddisease-free survival (both increased by 17 months)(P=0.811,0.799), as compared with those treated with postoperative radiotherapy, while in the patients with adenocarcinoma, the median overall survival anddisease-free survival were reduced by 11 and 9 months, respectively (P=0.330,0.115). ConclusionsCompared with postoperative radiotherapy, postoperative concurrent chemoradiotherapy for early-stage high-risk cervical adenosquamous carcinoma can reduce the rate of distance metastasis. Compared with radiotherapy, postoperative concurrent chemoradiotherapy for adenosquamous carcinoma and adenocarcinoma cannot improve survival time.
Wu Wanli,Yuan Shuhui,Lou Hanmei et al. Efficacy of postoperative concurrent chemoradiotherapy for early-stage cervical adenosquamous carcinoma and adenocarcinoma[J]. Chinese Journal of Radiation Oncology, 2016, 25(5): 477-480.
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2016, Vol. 25 
